Examining the social context of reproductive health behavior and outcomes

Whitney Smith, MPH, University of Alabama at Birmingham, 2015

Project abstract

Reproductive health behaviors and outcomes are the product of complex decision-making processes with multiple levels of influence. While a considerable body of literature examines the proximate and ecological influences, few studies have examined the role of social norms and stigmas. Researchers generally agree that social norms specify how individuals should behave in specific situations, and those who transgress these norms are often stigmatized.

To date, studies on the role of reproductive norms and stigmas have focused on isolated reproductive events. We use a more holistic approach to explore and compare reproductive norms and stigmas associated with unintended pregnancy, reproductive choices (i.e., parenthood, adoption, abortion), and their relationships with: 1) health behaviors as well as health outcomes (i.e., sexual activity, unprotected sexual intercourse, use of contraceptives, and experiencing an unintended pregnancy); and 2) reproductive health service utilization (i.e., the use of family planning, sexual health, gynecological and/or prenatal care services).

To achieve these aims, we will revise our previously developed Reproductive Stigmas questionnaire to add additional measures of reproductive service utilization, and administer the revised questionnaire to an additional 204 young (aged 19-24) women in Birmingham, Alabama. We hypothesize that women who perceive more reproductive stigma will engage in different unintended pregnancy risk behaviors, use of reproductive health services, and thus have disparate reproductive health outcomes compared to their counterparts.

Understanding the influence of reproductive norms and stigmas will help health care providers and public health advocates to better respond to the social atmosphere in which women make reproductive health decisions.